Echoes from the Operating Room : Vignettes in Surgical History


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Boyd, MD. The surgeon was. To download Echoes from the Operating Room: Vignettes in Surgical History Hardback eBook, make sure you refer to the web link listed below and download. Filesize: MB. Absolutely essential read book. It is probably the most. See all books authored by Carl R.

Mercenarys woman. Since the patient is the focus in all this, do they have a say in what's played during their own surgery? Now, I guess if you're the one going into surgery and you want to hear something as you go to sleep, well, you should certainly hear the music you like. On rare instances, the patient's requests go beyond that. Doherty says, "We once had a patient who was a musician who handed us five CDs of his personally recorded music to listen to because he wanted us to operate on him to HIS music.


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These primitive tests had many shortcomings, but they formed one of the earliest attempts to use medical screening as means to enhance workplace safety, and one of the first applications of large-scale health screening using a standardized test administered by trained, non-medical personnel. For more information, see Testing Vision and Hearing. Railway surgeons examined injured persons filing claims or lawsuits against the railroads. This arrangement created an awkward conflict of interest, and whether the doctors worked for the best interests of the patient or the company became a topic of heated debate.

Echoes from the Operating Room: Vignettes in Surgical History

The surgeons themselves struggled with this issue, as shown by the dozens of articles in The Railway Surgeon addressing the management of these delicate situations. The physicians vigorously defended their integrity, citing the objective nature of scientific inquiry in which they were trained. They denied receiving any encouragement from the railways to favor the company in their reports.

Smith, M. I do not believe there is a railway surgeon in all this big land of ours who would do an act or utter a word to defraud an honest claimant out of one cent due from the railroad. I challenge all comers to show an instance in which a railroad management, from the time an engine first awakened echoes amidst the solitudes of this great continent, up to this good hour, has refused or showed the least disposition to refuse the payment of any claim shown by the evidence to be just and right. I challenge all comers to name the railway surgeon who has attempted in his evidence before the courts to deprive an honest claimant of a dollar [49].

The western railroads traversed rural areas and fresh new settlements devoid of any substantial health care infrastructure.

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Outten noted that a person traveling between St. Louis and El Paso would go over miles without passing a single hospital [52]. The Central Pacific Railroad, under the direction of vice-president A. Towne, responded by opening its own hospital in Sacramento in [53].


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This institution, which most historians recognize as the first exclusive railroad hospital, served as a driving force for other railroads to develop their own facilities, and many more hospitals quickly appeared along the western rail lines. Eastern railroads passed through older, well-developed cities, and these railroads initially contracted with the existing hospitals rather than spending large sums of capital building their own institutions. Twenty-five years after the Central Pacific Hospital opened, the Illinois Central and the Pennsylvania Railroad still did not have their own medical facilities [55].

Nonetheless, the railroad-owned hospitals afforded convenience, control and the economies of scale and consolidation--benefits the eastern lines ultimately could not ignore. NARS president Dr. Brock of Virginia said in his address to the annual meeting:. The railway hospital plan is another admirable western product; and we of the east are glad to sit at the feet of these western Gamaliels and learn of them how to do these great things. Paul Acts ; Acts Sounding a more pragmatic note, the Long Island surgeon Dr. Railroad companies also hoped that providing generous benefits at company hospitals would foster goodwill, helping decrease injury-related lawsuits.

Reed observed.

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By , 13 railroads operated 25 hospitals, treating over , patients annually. Chaffee could not hide his enthusiasm with this growth.

Railroads retained private physicians under contract in cities along their lines. The railroad paid for this treatment regardless of whether the injured was an employee, passenger, bystander or hobo. Railroad employees received complimentary rail transport to the nearest company hospital, with ambulance transfers to and from the stations, if needed.

Railroad hospitals ranged from small facilities resembling private homes to large medical centers such as the bed Illinois Central Hospital in Chicago or the bed Southern Pacific Hospital in San Francisco. The industry reached a peak of 35 railroad hospitals throughout the country, providing a total of beds [62] see appendix. The larger ones offered a full range of services, including consultants from various medical specialties, and facilities and equipment that compared favorably with the top private and government hospitals of their day. The Santa Fe Hospital in Topeka, which opened in , boasted such innovative features as forced air ventilation with a full air exchange every 10 to 12 minutes, and independent heat control in each ward or room [63].

Many of these hospitals operated nursing schools, internships, and residency training programs. Some even manufactured pharmaceuticals [65] or raised their own farm products g.

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These were not true hospitals, but rather minor emergency clinics, typically housed in a one-room building and staffed by a single doctor and nurse. Descriptions of railway hospitals frequently mentioned efforts to create a relaxing environment for patients.

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Outten suggested that the camaraderie at a railroad hospital offered therapeutic value in itself. Louis, which opened in , provided musical instruments and a patient library with over volumes [68]. Railroad hospitals initially accepted only railroad employees. However, the lack of alternative facilities led hospitals in some areas to open their doors to the public.

The Alaska Railroad Hospital in Anchorage, for example, maintained by far the best facilities and equipment in the area when it opened in The hospital accepted non-railroad patients until Providence Hospital opened in The U. Eventually, many railroad hospitals accepted private patients to help fill unused capacity and generate revenue to reduce employee charges. Private patients paid higher fees, as the company did not subsidize their care.

Augustine provides an example of a large, busy railroad hospital. Operating from to , at its peak it maintained beds and provided all types of medical and surgical care, as well as a nurse-training program. Most patients stayed in large wards with beds, following the standard practice of the time.

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The hospital accumulated a budget deficit each year, which the railway absorbed [71]. Some railroads even operated long-term care facilities. Patients recovering from pneumonia, la grippe, rheumatism and other diseases of this class would be taken from the North to the sunny South. Typhoid, malarial and swamp fever cases would be sent North or to non-malarial sections of the country. The unfortunate consumptive would seek the West and Southwest, where he might not only find relief, but in time, employment. Only the best is good enough for our faithful railway men. If such a program were ever instituted, it was not recorded.

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The property, buildings and furnishings of a railroad hospital counted as fully taxable assets of the company. Many railroads opted to relieve themselves of a significant tax burden by creating independent foundations to own and operate the hospitals and health plans. These foundations, known as employee hospital associations EHAs , also benefited the employees by allowing them more representation in hospital management. The board of directors of an EHA hospital consisted of railway employees from a variety of occupations, typically one from each of the many unions representing them Table 4.

This stood in contrast to the company-owned hospitals, which were managed primarily by corporate officers.

Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History Echoes from the Operating Room : Vignettes in Surgical History
Echoes from the Operating Room : Vignettes in Surgical History

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